This invention, in general, relates to a health care organization. More particularly, this invention relates to utilization analysis and performance evaluation of providers in the health care organization.
Health care organizations, typically, comprise providers for providing health care services to consumers who enroll for a health plan of the health care organization. The operations of a health care organization depends on one or more factors including the number of consumers that enroll for the health plans, performance of the service providers, quality of the service provided by the service providers, management and utilization of the resources of the health care organization, etc. For an efficient operation of the health care organization, it is important to analyze the performance and quality of the service provider rendering health care services to the consumers. Furthermore, the cost of operation of the health care organization for providing health care services to the consumers in a plurality of health plans needs to be determined. Hence, there is an unmet need for a computer implemented method of effective utilization analysis and performance evaluation of providers in the health care organization.